Dr Hiro, MD-A day in the ER
by Hiro MD
Summary: In this Novel of Hiro MD series, Dr. Hiro Hamada, MD and his nurse bot Baymax has two cases to solve.
1. Case 1 Bloodwork

**It was a Saturday morning and I was sleeping in. well at least I tried when my pager went off. It was the Hospital so I call them. They wanted me in even it was my day off and turn into a work day. The reason I went into emergency medicine is my brother inspired me to ever slice he designed Baymax just before he died in a fire at nerd school university. I hoped in the shower and put on my scrubs on.I went downstairs and everybody was up. It was a few days before Christmas eve. I came downstairs carrying Baymax. Honey was making pancakes.**

Honey:"Your up early".

Hiro:"The Hospital called. Looks like Dad's working kids. Maggie, I sorry I really wanted to help you with you gingerbread house. Mom will help you".

Honey:"I also need to make her elf costume in her School play. It's on December, 23.

Hiro:"It's only December 7th dear. You have plenty of time of that".

Honey:"Don't forget breakfast".

Hiro:"No Time I'll grab something in the way. gotta go love you all".

Maggie:" Today's Saturday Dad".

Hiro:" Sorry sweetie.

 **I grabbed an energy drink out of the refrigerator and left the house.**

* * *

As I arrive at the Hospital carrying Baymax and went into the employee entrance with my badge, Crystal came up to me.

Crystal:"Sorry I paged you. Our waiting room is full and were short in Doctor's".

Hiro:"Okey.

Crystal:"There are donuts in the break room."

Hiro:"Great I'm hungry. I was in the rushed this morning.

I inflated Baymax to help me with patient to the exam. room. An ambulance pulled up the Children's ER. They rolled into a seven year old not responding.

Hiro:"What happen?"

Medic 1: A seven year old collated at a baseball game. The coach said that he was hit hard to the head with the ball.

The Family came in as soon as they herd the 911 call."

Nurse:"Family's here."

Hiro:"Put him in trauma 4. I need to speak to the family."

 **I came into the waiting room.**

Hiro: Hi I'm Dr. Hamada. I'll be working on your son. Does your son has a medical conditions

Mom:"Well he's bleeds pretty easy. It's a genetic thing. My Father had the same thing.

Hiro: A bleeding disorder. The coach told that your boy.

Mom:"Alex. His name his Alex".

Hiro:"Okey Alex was hit with a ball hard in a game.

Dad:"It was a baseball practice."

Hiro:"We think He bleeding from his brain. Were doing the best we can."

Mom:"One more thing. He gets migraines."

Hiro:"How offen he get these headaches"?

Mom:"Off and on."

 **I got my answer from the Mom and back in the ER to trauma 4.**

Hiro:"Baymax, Were going to need to get an MRI and a bleeding time test. I need to find out how long Alex bleeds. Mom said that He has a bleeding disorder and I may need to admit him. Also I need to do an EEG.

I asks the parents to fill out admitting papers. Baymax create a Hospital bracelet to put on him and put him in a grown. We wheeled him to MRI. I notice a metal medical alert bracelet on his arm so I took it off before putting him in the machine. As I looked at the images. I couldn't believe what I was seeing.

Baymax:"What is it"?

Hiro:"Looks likes a big blood clot in his Boy is having a stroke".

Baymax:"He's too young to have a stroke:"

Hiro:"Parents said it's a genetic thing. It's a bleeding disorder and he gets migraines.

All the sudden, Alex was holding his head screaming in pain.

Hiro:"Get him out of there. It's another migraines. Start him on morphine.

Baymax got him out of the machine and got out the I.V supplies ad started up on some morphine on him. Alex felt calm. We transfer him on the gurney and wheeled him to the EEG lab. Baymax paste 30 electrodes on his scalp. I looked at his brainwaves. I asks him to keeps his eyes open while I flash a light on him. His brainwaves changed.

Baymax:"Hiro Look?"

Hiro:"Looks like the blood clot was disturbing his brainwaves. The omy way to relieve that is brain surgery. However after surgery, He'll need to be in I.C.U. I need to call a Neurosurgeon. Baymax, Do me a favor and do a bleeding time test and write down how long he ben bleeding.

Baymax wrapped a blood-pressure cuff around Alex arm and pumped it up to pop an artery up. Clean off the test area, He then grabbed a scalpel to cut his artery. He started to bleed. He start up the stopwatch. Alex was bleeding to 45 minute's He was starting to feel dizzy and was gasping for air. Baymax apply an oxygen mask on him. Baymax inflate the cuff and control the bleeding to apply pressure and paged me. I rushed into Alex's room.

Baymax:"He's ben bleeding for 45 Minute's.

Hiro:"He has a bleeding disorder great work Baymax. I got all the information I need. The Neurosurgeon is on his way.

I suture up his surgical cut that baymax made for the test and put gauze pads on it. During the test, He lost half of his blood so I had to do a transfusion. The Neurosurgeon came into his room. I showed him his brain scans on his computer. I explain to him that my nurse bot just did a bleeding time test and it was a bleeding disorder. I was scratching my head thinking that How can He has a bleeding disorder when he had a blood clot on his brain.

Neurosurgeon:"That explain's it. Alex doesn't need surgery. That test could save his life".

Hiro:"What"?

Neurosurgeon: "Let's take another MRI".

 **We did an MRI and sure enough the blood clot was gone.**

Hiro:"Oh my gosh. That amazing."

Neurosurgeon:"Some how your nurse bot saved him".

Hiro:"Well I'm the one who ordered the test".

Neurosurgeon:"You make the right call. Draining his blood cured him. That treatment was first used in the medieval times".

 **We got hime out the machine. I just got the last piece of the puzzle. I was my nurse bot Baymax that treated him. The next day, Alex was discharge in good health. I wrote up a Prescription for blood thinners and gave it to the parents.**

Hiro:"He'll need to take these for the rest of his life. if he does take them, He need to have his blood drained. that explained the migraines.

Mom:"What do you mean"?

Hiro:"Sit down. When we did a MRI of his head, I notice a blood clot. When I ordered a bleeding time test, lucky to our surprise, We did another MRI, the clot was gone, However because the test required draining his blood, cause his to go into shock an he lost blood so I had to do a transfusion so taking these to keep him out of the Hospital. Oh because his medical condition, He'll needs to be careful or he'll bleed out. I notice some bruising on his arm so Baymax my nurse bot applied an ice pack. Have him take two of these everyday. one in the morning and one at night. We have a pharmacy downstairs. Oh Alex I have something for you.

I pulled out a small teddy bear with a get well shirt on him out from our toy bin.

Hiro:"This is for you and here is a sticker thats saids I'm Satisfied with my care with Baymax under it. It's my nurse bot that saved you life".

I ask Baymax come out and went up to Alex. Alex gave him a hug. Baymax turned his heater on to gave him a warm hug.


	2. Case 2 Bladderwork

**It was Tuesday and I was back at work. It was another day in the ER. I picked up another patients chart. It was another medically need child. an three year old Kristen. I went into an exam. room. The Mother was reading a magazine. Kristen was in a wheelchair in a gown.**

Hiro:" Hi. I'm Dr. Hamada and looks like on your chart that you have a spinal injury and I see you have a Foley catheter with a leg bag".

Kristen:"I cannot complete empty my bladder".

Hiro:"Well that common in spinal injuries".

 **I went over to her and carry her to the gurney. Wash my hand and got my gloves on. I** **began to feel around her back.**

Hiro:"Does this Hurt?"

Kristen:"No."

 **I put my stethoscope on and listen to her lungs.**

Hiro:"Dep breath."

 **I lay her back down and looked at her leg bag and there was blood coming out of the catheter.**

Hiro:" I may have to order Cystoscopy Kristen, I need to look inside your bladder through a scope then were going to change your catheter. Okey, I'll sent my nurse bot in to remove her catheter and I'll meet you guys in the procedure room and well need to get her vital's. I may need to admit her in for more tests.

 **I close the door and hand Baymax her chart. Baymax came in and took her catheter out and took her vital sign's. He hand her Mom some admitting forms to sign's and sign a consent for the test. Baymax carried her back on the chair and wheeled her down to the** **procedure room and carried her to the table and put her feet up on the stirrups and draped her to the waste down. I put the scope in her bladder and filled her bladder up with water. Kristen was screaming in pain. Baymax calmed her down.**

Hiro:"I'm almost done. I need a few more minute's. Baymax hand me a specimen cup. I need to do a biopsy.

 **I biopsy a piece of her bladder and put it in a specimen cup to take to the lab. I use a straight catheter and empty her bladder before taking the scope out.**

Hiro:"Baymax were going to need a foley catheter kit.

 **Baymax prepared the sterile field of the foley catheter kit. I did the catherizion procedure. Baymax put her Hospital bracelet around her arm and carries her to the gurney and I hung her catheter bag and put a blanket on her. I had Baymax wheel her upstairs while i talk to the family. I went out in the waiting area talk to her mother. Her dad is in** **prison.**

Hiro:"Is there any medical history I need to know about"?

Mom: Well she was born with a urinary retention disorder along with spina bifida. Doctor's couldn't save her. The birth last for 2 days. I had to had a c-session and Doctor couldn't figure out what was wrong. We went to a orthopedic and a urologist. Also a neurologist She had to be in diapers until she was three. Also she gets lot of bladder infection The first infection she got destroyed her sphincter muscle and could not control her urine so that's why she end up with a catheter. Is there any treatment?"

Hiro:" Will what we could put an artificial sphincter in with requires surgery but were worried about the infection. I can clear up the infection with I.V antibiotic's. Will be monitoring vital plus her urinary output. I need to keep her in the Hospital for three weeks. After the infection clears up, she'll need to fast for 12 hours before the surgery.

Mom:"How long the antibiotic's take effects?"

Hiro: "About 48 to 75 hours. If you sign this consent, will get on with the treatment".

Mom:"Any side effects?"

Hiro:"She could develop a fever,Nausea Blood-pressure may drop. She may have to be isolated.

 **I had Mom sign a consent form for it. Lab came back for from the biopsy. She had a bladder infection. I came back in her room with a urine meter. I clamped the catheter, unhook the cather bag and hook up the urine meter and unclamped the catheter. I asks Baymax start up an I.V. on her and hook up the medicine for her I.V. tubing and I start up the infusion pump. I went to the** **Nurses office to look at her chart.**

Crystal: So what did the Mother say?

 **I showed Cystal Kristen's chart.**

Crystal:"So this child has a lot of medical problem's".

Hiro:"Mother said it's all genetics. I need to order some tests, EEG,MRI of the brain, Kidney function test and an X-ray of her spinal cord also a spinal tap just to make sure her infection doesn't spread. I put her on I.V antibiotic's for UTI. I need to go to my daughter's School. she's in a Christmas play. She an Elf".

Crystal:" What the title?"

Hiro:"Santa's workshop. It's stat at 6:00pm. Make sure you perform those test's I order.

 **I Got my coat and left the Hospital and got to my daughter's School. I got there at 5:00pm. We went into Maggie's classroom. She show us what she's ben doing. She showed us her science project. It was 5:35pm. It was time to go to the gym to take our seats. Maggie went back stage to put her Elf costume on. The play open up with a bell choir playing Jingle Bells. The certain's open and there a santa's workshop scene. My daughter was sitting at the table with her other friends painting wooden cars. Santa entered within a 5th grader to sat on his chair check his lists. The choir starting singing" Santa clause is coming to town"Mrs. clause was at the edge of the stage baking cookies. Later in the play, The Elves were wrapping up present's for santa to do his night time duty. It was 7:00pm. The play was over. In the hallway, we had Christmas cookies and Hot Chocolate and talk to other families. We went home after that. The kids went upstairs and got ready for bed.**

* * *

 **Few day later, The infection cleared up and she was clear for surgery to implant an artificial sphincter. The Mother was in the surgical waiting area. an 3 Hours went by , I came out from surgery.**

Hiro:"Surgery went well. You can see her in recovery".

 **The mother went to recovery. She was no longer on the catheter. She was waking up.**

Mom:"You Dad's out of jail".

Kristen:"What was he in for?"

Mom:"Is something you don't need to know. the thing is that your off the catheter

Hiro:"Were going to keep her for a while. The device I implanted operates on the computer. I need to program the artificial sphincter. But first, I like to see if she can hold her urine in so I can find out what level I need to program at. I need to run some tests to see if it's going to work.

Mom:"So this is an experimental treatment?"?

Hiro:"Yes. It may cure her urinary retention disorder. It will help her control her bladder more. It's sort of a training device for her sphincter muscle. It supposed to re-program the brain. If it helps, Will remove the device."

Mom:"How long does it take to re-program the brain"?

Hiro:"It depends,"

 **I look at my watch.**

Hiro:"Well visiting hours are over. You can see you tomorrow"?

The Mom kissed her daughter and left the Hospital. I had Baymax wheel in the Bladder scanner unit in the room. I lift her gown up, turn on the unit, use the wound to press down were her bladder is. The unit was scanning her bladder. her bladder was quarter full. I printed out the report and wore it on her chart.

Hiro:"You know Kristen, with the device in, It's going to help you to hold in your pee like everybody else unit your ready to use the toilet. for now on, It not turned on because I need to do some tests before turning it on from the computer. You may feel your bladder filling it up. I need to do a couple of scans to check for volume. I need you to drink water to fill your bladder".

Baymax:"Hiro? Can I talk to you?"

Hiro:"What is it Baymax"?

Baymax:"You know I can be a bladder scanner."

Hiro:"You can"?

Baymax:"I'm program to do over thousand medical procedure's".

Hiro:"Great. So I can wheeled this back in the supply storage, Make sure you write down on her chart".

Baymax: Even better. I can fax it to you from my health care chip."

Kristen:" Dr. Hamada"?

Hiro:"Yes sweetheart"?

Kristen:"Can I have some ice-cream"?

Hiro:"Sure. I'll be back.

 **I call kitchen to ask them to bring them up some ice cream to room 405 west wing. 1 Hour later, Baymax press his fat hands on her belly were her bladder is to scan her bladder. Her volume showed up on his chest. Baymax photo copy thee diagram and faxed it to my office with his built in WiFi. Before It left, I put in a Foley catheter in with a drainage bag since the device wasn't programed.**

Kristen:"I thought no more catheters."

Hiro:"The device that I implanted is not programmed in yet so it doesn't work yet. I have all the information I need thanks to Baymax so I need to figure out what level I need to program at. Meantime you need stay on the catheter".

Kristen:" How is programing it has to do with it?"

Hiro: It starts to re-program the brain to learn to hold your urine in until you find the bathroom to use and when your sphincter muscle get stronger enough, I'll remove the device. Then you'll live a full life without catheters

 **Kristen smiled at me and I walked out of her room with her chart. The next day, I was ready to program her artificial sphincter. Baymax took her catheter out and I programmed the device.**

Hiro:"You may feel a little tangling that because I'm programming the device.

 **Which a tangling, the brain started to get re-programed. For the first time she was holding her urine no drips and got discharged. she was sitting on the toilet and it relaxed the artificial sphincter and urine came next day, Kristen had a follow-up in my office. 2 years later, her sphincter muscle was stronger and the device was removed by outpatient surgery. She now has a full life without a catheter. She did goes to the restroom with no problem. I believe I found a cure for urinary retention disorder. The FDA approved the experimental treatment an I got a big pay raise from my boss crystal plus a long pay vacation and we took the kids the disney world.**

* * *

 **The end.**


End file.
